Provider Demographics
NPI:1073941787
Name:ROBB, TANYA R
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:R
Last Name:ROBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TANAY
Other - Middle Name:R
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1112 W 6TH ST STE 216
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2249
Mailing Address - Country:US
Mailing Address - Phone:785-841-1107
Mailing Address - Fax:785-841-1173
Practice Address - Street 1:1112 W 6TH ST STE 216
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2249
Practice Address - Country:US
Practice Address - Phone:785-841-1107
Practice Address - Fax:785-841-1173
Is Sole Proprietor?:No
Enumeration Date:2013-10-16
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76053-091363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner